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Objective:To explore the application value of online and offline interactive teaching combined with three-dimensional quality theory mutual evaluation in the standardized residency training of general practitioners.Methods:Twenty-four general practitioners who were trained in The Second Hospital of Tianjin Medical University from January 2019 to December 2019 were selected as the control group, receiving traditional teaching; another 22 residents who were trained from March 2020 to February 2021 were selected as the observation group, taking online and offline interactive teaching combined with mutual evaluation of three-dimensional quality theory. After the training, the theoretical knowledge, skill operation and case analysis assessment scores, clinical ability and teaching satisfaction were compared between the two groups. SPSS 25.0 software was used for t test and rank sum test. Results:There was no significant difference in the scores of theoretical knowledge assessment, operation skills assessment, and case analysis assessment between the two groups before the training. After the training, the scores of the two groups were all increased, and the observation group had higher scores than the control group ( P<0.05). There was no significant difference in the scores of each dimension in the Direct Observation of Procedural Skills (DOPS) scale between the two groups before training, while after training, the scores of each dimension in the DOPS scale of the two groups were increased ( P<0.05), and the scores in the observation group were higher than those in the control group. The difference of mutual evaluation results after the training between the two groups was statistically significant, and the results of the observation group were higher than those of the control group ( P<0.05). Conclusion:The application of online and offline interactive teaching combined with mutual evaluation of three-dimensional quality theory in the standardized residency training of general practitioners can help improve the theory, skill practice, case analysis assessment performance and clinical ability of residents, and also obtain higher teaching satisfaction.
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Objective:To investigate the effect of Jiaomu Gualou Decoction combined with bisoprolol on myocardial microcirculation and oxidative/antioxidant balance in patients with heart failure.Methods:A total of 128 patients with heart failure who met the inclusion criteria from March 2020 to February 2021 in Dagang Hospital of Traditional Chinese Medicine, Binhai New Area, Tianjin were divided into 2 groups by random number table method, with 64 in each group. On the basis of conventional treatment, the control group was given oral bisoprolol, and the study group was given Jiaomu Gualou Decoction and oral bisoprolol. Both groups were treated continuously for 4 weeks. TCM syndrome scores were performed before and after treatment. The left ventricular ejection fraction (LVEF), left ventricular end-systolic diameter (LVESD), and left ventricular end-diastolic diameter (LVEDD) were detected by ultrasonic diagnostic equipment, and the frequency, duration and total myocardial ischemia load of the 24-hour ECG were recorded. Lipid peroxide (LPO) was detected by fluorescence method, SOD, MDA and GSH-Px were detected by colorimetric method. The adverse events were recorded and clinical response was evaluated.Results:The response rate was 93.75% (60/64) in the study group and 79.69% (51/64) in the control group, and the difference between the two groups was statistically significant ( χ2=5.49, P=0.019). After treatment, the scores of shortness of breath, phlegm, sternocostal fullness, and fatigue in the study group were significantly lower than those in the control group ( t values were 8.48, 8.15, 8.86, and 6.88, respectively, all Ps<0.001). After treatment, the LVEF of the study group [(53.26±5.18)% vs. (48.65±5.27)%, t=4.99] was significantly higher than that of the control group, and the LVESD [(42.59±3.26) mm vs. (46.98±3.55) mm, t=7.29], LVEDD [(52.79±4.15) mm vs. (57.48±4.60) mm, t=6.06] significantly lower than the control group ( P<0.01). After treatment, frequency of ST segment fall [(2.51±0.42) times/24 h vs. (3.79±0.55) times/24 h, t=14.80], duration [(15.26±3.45) min/24 h vs. (22.65±3.71) min/24 h, t=11.67] and total myocardial ischemia load [(25.79±5.13) mm/min vs. (38.02±5.44) mm/min, t=13.09] were significantly lower than those in the control group ( P<0.01). After treatment, the levels of serum GSH-Px and SOD in the study group were significantly higher than those in the control group ( t values were 10.97, 14.37, respectively, all Ps<0.001), while the levels of LPO and MDA were significantly lower than those in the control group ( t values were 7.50, 11.04, respectively, all Ps<0.001). During the treatment period, the incidence of adverse events was 4.69% (3/64) in the study group and 7.81% (5/64) in the control group, with no significant difference between the two groups ( χ2=0.13, P=0.715). Conclusion:The Jiaomu Gualou Decoction combined with bisoprolol can improve the cardiac function and myocardial microcirculation in patients with heart failure, promote the body's oxidation/antioxidant balance, relieve the clinical symptoms of patients, and improve the response effect safely.
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Objective To investigate the possibility of neutrophil-to-lymphocyte ratio (NLR),platelet-to-lymphocyte ratio (PLR) and mean platelet volume (MPV) as biomarker for early atherosclerosis in patients with newly diagnosed type 2 diabetes.Methods 420 newly diagnosed type 2 diabetes were enrolled in the study.They were divided into three groups:patients with normal carotid artery were group A (n =152),patients with unilateral carotid plaque were group B (n =138),patients with bilateral carotid plaque were group C (n =130).Their neutrophil,lymphocyte,mean platelet volume,lipid and glucose,carotid intimal medial thickness (CIMT),ankle brachial index (ABI) were all performed in these individuals.Results Compared with group A,the age,systolic pressure,neutrophil count (NC),platelet count (PLT),NLR,PLR,low density lipoprotein-cholesterol (LDL-C),total cholesterol (TC),fasting blood glucose (FBG),hemoglobin A1c (HbA1c) and CIMT were higher while ABI were lower in group B and group C;Compared with group B,the age,systolic pressure,NC,PLT,NLR,PLR,LDL-C,TC,CIMT and were higher while ABI was lower in group C (P ＜ 0.05).CIMT was positively correlated to age,systolic pressure,NLR,PLR,LDL-C,TC,FBG and HbA1c (P ＜ 0.05) while ABI was negtively correlated to age,NLR,PLR,LDL-C,FBG and HbA1c (P ＜ 0.05).In multiple linear regression analyses,after adjustment for age,lipid,glucose and so on,NLR and PLR were also significantly correlated to CIMT and ABI.Conclusions NLR and PLR were significantly correlated with CIMT and ABI in newly diagnosed type 2 diabetes.Therefore,NLR and PLR may have the potential to serve as biomarkers for early arteriosclerosis in type 2 diabetic patients.
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Objective To investigate the prevalence of metabolic syndrome (MS) and its components among the elderly at Tanggu community in Tainjin. Methods The elderly inhabitants were drawn out randomly from one community at Tanggu in Tianjin to examine the MS-related indexes. There were 623 samples with complete data aged (67.4±6.0) years, including 261 males with mean age of (68.3±6.1) years and 362 females with mean age of (66.9±6.0) years. Diagnosis of MS was done by criteria of Chinese Medical Association Diabetes Branch in 2004. Results The standardized prevalence of MS for the elderly in the community was 18.5% with the highest risk group aged 60～69 years. Standardized prevalences of hypertension, high triglycerides, high blood sugar, overweight, obesity, low HDL-C were 49.5%, 38.8%, 25.3%, 42.0%, 4.2%, 3.0% in the elderly. Conclusions The prevalence of MS in the elderly is lower in Tanggu community in Tianjin than in Shanghai, Foshan in Guangdong, Qingdao in Shandong and Beijing city. The condition in female is more severe than in male, the highest prevalence occurs in hypertension, and overweight, high triglycerides and high blood sugar follow it, but few of them are obesity, low HDL-C is fewer too.
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Objective To explain the physiological properties of serum leucine aminopeptidase (LAP) and discuss the different levels and clinical meaning of serum LAP during the second and the third trimester of gestation.Methods Rate turbidimetry was used to assay serum LAP activity of 175 pregnant women in the second trimester of gestation, among whom 162 were normal and 13 were intrahepatic cholestasis of pregnancy (ICP), and 302 pregnant women in the third trimester of gestation, among whom 215 were normal, 76 were ICP, 6 were pregnancy-induced hypertension syndrome and 5 were premature delivery, and 100 healthy or non-pregnant women.Results Serum LAP activity of pregnant women in the group of the second trimester of gestation was (140.43?64.39) U/L, in the group of the third trimester of the gestation was (234.72?93.53) U/L, and in control group was (72.62?15.31) U/L. The serum LAP activities of the two pregnant groups were much higher than that of control group (P
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Objective To investigate the Th1/Th2 polarization of T lymphocytes in human peripheral blood stimulated by CpG-ODN2216,and the secretion of cytokines in supernatant of cultured PBMCs after stimulation of CpG-ODN2216.Methods Human PBMCs were isolated from blood of donors.The PBMCs were incubated with CpG-ODN2216 for 24 hours.Th1/Th2 subsets in the cultured PBMCs were examined by flow cytometry,and IFN-?,IL-2,IL-4 and IL-10 in the supernatant were assayed by ELISA.Results The percentage of Th1 and Tc1 increased significantly after stimulation of CpG-ODN2216 compared with control group (P0.05).Conclusion The Th1 cells and Tc1 cells in T lymphocytes of peripheral blood could be polarizated by CpG-ODN 2216.IFN-? secretion in PBMCs could be induced by CpG-ODN2216.
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To reverse drug resistance mediated by the MDR1 gene product P-glycoprotein(P-gp) in tumor cells in a specific manner, a hammerhead ribozymes which can cleave the GUC sequence in codon 196 of MDR1 mRNA was designed and cloned into a recombinant retroviral vector pDOR-neo at BamH I restriction sites and packaged with packaging cell line PA317 cells.The viral supernatant was used to infect the multidrug-resistant human hepatocarcinoma cell line BEL-7402/DOX. After selection with G418,resistant colonies were obtained.Stable expression of retroviruses in both PA317 and infected BEL-7402/DOX cells was confirmed by Northern Blot hybridization. Down-regulation of P-gp and even of MDR1 mRNA was found in BEL-7402/DOX infected with ribozyme construct. The rate of BEL - 7402/DOX infected cell defected by flow cytometric analysis was 8.2 ~ 14.6% while in uninfected cell it was 93 .4 ~ 97.5% . The BEL-7402/ DOX cell infected with ribozyme construct was found back to drug-sensitivity to a series of drugs by MTT colorimetric assay . The results demonstrated that the recombinant retroviral vector expressing ribozyme transfecting human hepatocarcinoma BEL-7402/DOX could inhibit MDR1 gene expression and reverse tumor MDR phenotype back to drug-sensitive condition.